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(22) Anti-neutrophil cytoplasmic antibodies directed against proteinase 3 produce a cytoplasmic pattern reflected in the term c-ANCA. Antineutrophil cytoplasmic antibodies directed against myeloperoxidase typically produce a perinuclear pattern (pANCA).
Pathologists reported crescentic, focal necrotizing glomerulonephritis and vasculitis after the kidney biopsy, which was performed because of the high level of c-ANCA. We later diagnosed the patient as Wegener granulomatosis and started a treatment of pulse steroid together with a planned i.v.
(36) The staining of ANCA reaction with proteinase 3 will result in a cytoplasmic fluorescent pattern called c-ANCA. The pANCA pattern of perinuclear staining around the nuclei of neutrophils is the second type of pattern noted.